How is shoulder impingement treated?

Shoulder impingement is a common condition that occurs when the tendons or bursa in the shoulder become compressed or irritated as they pass through the narrow space between the top of the upper arm bone (humerus) and the shoulder blade (acromion). This can lead to pain, weakness, and limited range of motion, especially when lifting the arm, reaching out or performing overhead activities.

The most frequently affected structure is the rotator cuff tendon, which becomes pinched during shoulder movements. Over time, repetitive motion, poor posture, or injury can cause swelling and inflammation, leading to chronic impingement. Athletes, manual laborers, and older adults are particularly susceptible.

Symptoms include shoulder pain that worsens with activity, tenderness, and sometimes a catching sensation. Diagnosis typically involves a physical exam, imaging studies such as X-rays or MRI, and an assessment of your medical history.

Treatment usually begins with conservative approaches like rest, physical therapy, anti-inflammatory medications, injection and activity modification. In many cases, these non-surgical treatments effectively relieve symptoms within a few weeks to months.

However, surgery may be required if symptoms persist despite conservative care for 6–12 months, or if there is significant damage to the rotator cuff. The most common surgical procedure for shoulder impingement is arthroscopic subacromial decompression. This minimally invasive surgery involves removing inflamed tissue or shaving part of the bone to increase the space for tendons to move freely.

Surgical intervention aims to relieve pain, restore mobility, and prevent further tendon damage. Recovery varies, but most patients can return to regular activities within a few months with proper rehabilitation and regular home exercises to improve the rotator cuff strength. Surgery alone will not work. If shoulder pain interferes with your daily life or doesn't improve with rest and therapy, it's important to consult an orthopedic surgeon to discuss whether surgery is the right next step.